Dual Coding ICD-10 and ICD-9: When and How

Everyone in your practice is trained and ready, and on Oct. 1, 2015, like it or not, you're going to start using the new ICD-10 diagnosis codes. ICD-9 will be a thing of the past. Well not quite. There will be a period of time when you may have to use both coding systems. If you take the right approach, however, you can keep that overlap period brief.

Ken Bradley, ICD-10 expert and vice-president of strategic planning and regulatory compliance at medical claims clearinghouse Navicure, points out that you need to be prepared to be bilingual when it comes to codes for some time after the new codes take effect.

Which code set you use will depend on the date of service. Claims with a date of service before October 1 will need to be coded in the ICD-9 system - even if those claims are not submitted until after October 1. Claims with a date of service of October 1 or later must use the ICD-10 system. CMS will not accept a claim with more than one code set. You must use either all ICD-9 or all ICD-10, so in some cases, you may have to split a claim.

You'll want to keep this bilingual phase brief, and there are ways to do just that.

"It is very important to streamline processes now such as turnaround times for submitting claims and denial management," said Asia Blunt, an AAPC certified coder and trainer. "For example, if a patient is seen today, that visit should be documented, coded, and submitted ideally within 24 hours, and no later than the next business day. Streamlining these processes now will cut down on how long your practice has to use overlapping codes. The shorter the time period, the better." Streamlining will also help reduce cash-flow problems during the transition.

Of course "ideal" situations rarely occur, and you may be chuckling at the idea of a 24-hour turnaround time, especially during the ICD-10 learning curve. In order to know what to expect, Bradley suggests taking a close look at your claims history.

"See how long a typical claim is open, and that will give you an idea of how long you'll need to use both sets of codes (though, again, never on the same claim)," said Bradley. By knowing what kinds of claims tend to stay open a long time, you'll have a better idea of how and where you need to tighten up your billing process.

It won't be a long, graceful phase-in from ICD-9 to ICD-10; October 1 is the day. But there will be some overlap. That shouldn't be a big deal, if you're aware of it and prepared. Just don't throw out that ICD-9 book too soon.